IXPN Application Form

Name of Organisation
Organisation Registration No.
Organisation Registered Address
Organisation Postal Address (if different)
Organisation Telephone
Organisation Fax
Administrative Contact
Administrative Contact Person-Name
Administrative Contact Address
Administrative Contact Telephone
Administrative Contact Fax
Administrative Email Address
Technical Contact Name
Technical Contact Address
Technical Contact Phone
Technical Contact Fax
Technical Contact Email
Billing Contact Name
Billing Contact Address
Billing Contact Phone
Billing Contact Fax
Billing Contact Email
Sales Contact
Sales Contact Address
Sales Contact Phone
Sales Contact Fax
Sales Contact Email
AS number(s) to use for peering
Required Port Capacity (10Mbs 100Mbs 1Gbs 10Gbs )
Required Number of Ports
IXPN location to connect to (NCR, Medallion, Rack Center, Abuja, Port-Harcourt, Kano)
Operational 24x7 NOC Phone
Have you read the MoU?
Type of permanent connection(s) to the internet that you have?
Bandwidth of the Connection
Please list your Upstream Provider(s) and their AS number(s)
Please provide a brief description of your organisation
Organisation URL
Please Enter the word as seen
Please Enter the word as seen